SECLUSION Autosaved 1
SECLUSION Autosaved 1
SECLUSION Autosaved 1
EMOTIONAL CONCERNS
Learning Objectives
• WHEN MAKING DECISION ABOUT WARNING A THIRD PARTY, THE CLINICIAN MUST
BASE HIS OR HER DECISION ON THE FOLLOWING:
Is the client dangerous to others?
Is the danger the result of serious mental illness?
Is the danger serious?
Are the means to carry out the threat available?
Is the danger targeted at identifiable victims?
Is the victim accessible?
TORTS
4. CAUSATION: the breach of duty was the direct cause of loss, damage,
or injury. In other words, the loss, damage or injury would not have
occurred if the nurse had acted in a reasonable, prudent manner.
TORTS: INTENTIONAL
• Psychiatric nurses may also be liable for intentional torts or
voluntary acts that result in harm to client. Examples are
ASSAULT, BATTERY, AND FALSE IMPRISONMENT.
ASSAULT: involves any action that that causes a person to fear
being touched in a way that is offensive, insulting, or physically
injurious without consent or authority.
BATTERY: involves harmful or unwarranted contact with a client;
actual harm or injury may or may not have occurred.
FALSE IMPRISONMENT: the unjustifiable detention of a client,
such as the inappropriate use of restraint or seclusion.
…cont…TORTS: INTENTIONAL
Practice within the scope of state laws and nurse practice act.
Collaborate with colleagues to determine the best coarse of action.
Use established practice standards to guide decisions and actions.
Always put the client’s right an welfare first.
Develop effective interpersonal relationships with clients and families.
Accurately and thoroughly document all assessment data, treatments,
interventions and evaluations of the clients response to care.
ETHICAL ISSUES
• The nurse assess the client for any injury and provides treatment as
needed, monitors and documents t he client’s skin condition, blood
circulation in hands and feet (for the client in restraints), emotional
being, readiness to discontinue seclusion and restraint.
• Also, observes the client closely for side effects of medications, which
may be given in large doses in emergencies.
• The nurse or designated care provider also implements and documents
offers of food, fluids, and opportunities to use the bathroom per facility
policies and procedures. ASAP, staff members must inform the client of
the behavioral criteria that will be used to determine whether to
decrease or to end the use of restraints or seclusion.
… cont… APPLICATION OF SECLUSION
• CRITERIA MAY INCLUDE:
Client’s ability to verbalize feelings and concerns rationally, to make no verbal
threats, to have decreased muscle tension, and to demonstrate self-control.
- HUMAN RESTRAINT- occurs when staff members physically control the client and
move him or her to a seclusion room.
- MECHANICAL RESTRAINT-are devices, usually ankle and wrist restraints, fastened to
the bed frame to curtail the client’s physical aggression, such as hitting, kicking and
hair pulling.
Mechanical restraints
Human restraint
TYPES OF RESTRAINT
1. BELT RESTRAINT
…CONT…TYPES OF RESTRAINT
2. JACKET RESTRAINT
…CONT…TYPES OF RESTRAINT
• 3. MITT RESTRAINT
…CONT…TYPES OF RESTRAINT
4. WRIST OR ANKLE RESTRAINT.
…CONT…TYPES OF RESTRAINT
5. ELBOW RESTRAINT
RESTRAINT